Provider Demographics
NPI:1851369383
Name:ZHANG, CHUNYUE (MD)
Entity Type:Individual
Prefix:
First Name:CHUNYUE
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHUNYUE
Other - Middle Name:CARRIE
Other - Last Name:ZHANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5801 W IVYBRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615-9289
Mailing Address - Country:US
Mailing Address - Phone:309-692-1067
Mailing Address - Fax:309-692-1067
Practice Address - Street 1:221 NE GLEN OAK AVE
Practice Address - Street 2:METHODIST MEDICAL CENTER OF IL
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61636-0001
Practice Address - Country:US
Practice Address - Phone:309-672-5654
Practice Address - Fax:309-680-2473
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036110861207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036110861Medicaid
ILI17425Medicare UPIN
IL036110861Medicaid